Stop blaming doctors for antibiotic abuse

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According to the World Health Organisation’s latest report into antibiotic resistance we are facing a ‘problem so serious that it threatens the achievements of modern medicine… A post-antibiotic era, in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century.’ Bloody frightening stuff if you ask me.

Naturally the prime suspects in this whodunnit are the much-maligned medical profession, guilty of giving out antibiotics like sweeties in a tuck shop while the human race barrels toward a future in which we are going to die of diseases at which–thanks to antibiotics–we barely bat an eyelid today.

Are they truly the culprits in this case? In investigating this deplorable state of affairs, one must be thorough and ask the question: ‘Who else could be to blame? Who else uses large amounts of antibiotics?’

The answer to this is the unassuming, altruistic, not-for-profit agricultural industry, dedicated to the betterment of humanity via the provision of cheap and affordable meat and dairy products. But perhaps I have misrepresented it: according to the Soil Association, approximately 50 per cent of antibiotic use occurs in the intensive livestock industry, required to overcome the unhealthy conditions they are kept in.

Modern commercial farming is essentially the exploitation of animals in order to maximize profits. Money is saved on the provision of humane living conditions by packing as many animals into as small a space as possible. Battery farmed chickens, livestock and cattle are kept in deplorable conditions prior to being sent for slaughter. Antibiotics are added to their feed to keep them healthy and to help in fattening them up. This by definition means that more hardy organisms are selected and hence antibiotic resistance becomes widespread.

Resistant bacteria can then spread to animal products, to vegetable or fruit produce through contaminated water or soil, to prepared food through contaminated surfaces and to the environment when animals pass waste products. This is not just theoretical; the food-based outbreaks of E.coli that occurred in 2006 in the US, and in 2011 in Germany and the UK, where a significant number of people lost their lives, illustrate the practical consequences of antibiotic resistance.

The agriculture lobbies both in the US and the UK are formidable influencers of government. This has been amply demonstrated by the fact that the Food and Drug Administration in the US refuses to ban unnecessary antibiotic use in the agricultural industry. Instead it has released non-binding guidelines that allow farmers to prescribe antibiotics to healthy animals under the pretext of disease prevention or growth promotion. It is an effective license to treat all animals with antibiotics, and maximise the bottom line.

MRSA and resistant strains of E.coli have been found both in hospitals and commercially-run farms. A coincidence? I think not.

Do doctors sometimes misprescribe antibiotics? Undoubtedly. But medics’ occasional overprescribing pales into insignificance when compared with what occurs in industry. And patients play a part either by demanding unnecessary antibiotics and failing to completely finish prescribed courses. Those are both common occurrences, but I have yet to hear calls for patients’ heads.

If mass antibiotic resistance occurs it will be because of governments afraid to confront the agriculture lobby and introduce the legislation necessary to stop the unnecessary use of antibiotics in livestock. It won’t be because GPs or hospitals doctors are irresponsible in their use of antibiotics.

Antibiotics have saved the lives of countless patients since their discovery, and continue to do so. Their use must be restricted to the medical and veterinary sphere, with all other use banned forthwith – unless of course governments wish for a world where people die of a simple paper cut.